Pricing
Built on real denial data. Priced for the operational reality of your team.
The 6QD Denial Playbook covers 51 unique CARCs, 117 CARC+RARC pair scenarios, and 42 CARC-only scenarios — built and maintained by revenue cycle subject-matter experts.
Public Reference
Free
Best for: Anyone researching a CARC denial code
- Search across all 272 CARC denial codes
- Plain-language code descriptions
- Denial category badges
- "In our library" indicator for codes with full SOPs
- Email-capture for subscriber-tier preview
Operational Playbook
Foundation
$4,990/yr (save 17%)
Best for: Physician groups, billing companies, RCM consultants
- All 159 SOPs — decision matrix, argument framework, 6–8 step work instructions
- All 156 Template Letters with smart placeholder system
- Tier classification (Tier 1 / 2 / 3) per scenario — for staffing decisions
- Automatable flag (Yes / Claim Scrubber / Partial / No) — for bot-vs-rep routing
- Technical / Clinical / Mixed skill designation — for queue routing
- Master Classification (Administrative, Coding, Clinical, Payment Variance, etc.)
- Classification Map CSV export — covers your 156 curated scenarios
- Filter by tier, denial type, technical/clinical, automatable
- PDF export of any SOP for offline use
- Up to 5 users
- Email support, 48-hour response
Full Intelligence Stack
Professional
$9,990/yr (save 17%)
Best for: 50–300 bed hospitals, large RCM firms, multi-site practice groups
- Everything in Foundation, plus:
- All 79 Facilitator Guides — training-ready, 9 sections + 8 learning objectives each
- Pareto reports — upload your denial mix, get a ranked workplan
- FTE capacity model — directional staffing recommendations by tier
- Tiers Master read-only access — full 2,071-row taxonomy, searchable in-app
- Conditional path logic for authorization denials (CARC 197 family)
- Custom-branded PDF export
- Up to 25 users
- Quarterly office hours with 6QD SMEs
- 24-hour support response
Health Systems & RCM Vendors
Enterprise
$25k–$150k/yr (NPR-tiered)
Best for: Health systems and large RCM platforms
- Everything in Professional, plus:
- Tiers Master full dataset export — 2,071 rows × 36 columns, CSV/JSON, refreshed quarterly
- API access — pull SOP content + tier classification into Epic, Cerner, Waystar, Cedar, etc.
- Unlimited users
- Quarterly content updates as CMS issues new CARC codes
- 1 custom payer overlay included (UHC, Anthem, etc.); additional at $15k each
- Dedicated Slack/Teams channel with 6QD team
- Annual 2-day on-site workshop with custom denial inventory mapping
- Quarterly customer council — roadmap input
Add-Ons & Standalone Products
Attach to any tier — or buy standalone.
Some teams want the full subscription experience. Others want just the data, or training, or white-label rights. Each add-on stands alone, and most can be bundled into Foundation, Professional, or Enterprise.
$4,999/yr
$999/month
Tiers Master Data License
Standalone access to the full 2,071-row × 36-column Tiers Master taxonomy. For analytics vendors, denial-prevention SaaS, or BI teams that want the data layer without the SOPs.
Delivery: CSV export + API endpoint for tier classification lookups
Best for: Analytics platforms, denial-prevention vendors, RCM platforms
$5,000/yr
New-CARC Issuance Retainer
When CMS issues a new CARC code, you get a fully-structured SOP — decision matrix, argument framework, step-by-step, template letter — within 30 days. Maintained by our SME team.
Delivery: Auto-published to your subscriber portal
Best for: Foundation+ customers who need to stay current
$15k–$50k
per payer
Custom Payer Overlay
Payer-specific deviations woven into our existing SOPs — UHC commercial, Anthem BCBS, Medicare Advantage, etc. Your reps see "for UHC specifically..." callouts directly in the work instructions.
Delivery: Inline annotations across all relevant SOPs
Best for: Professional and Enterprise customers with concentrated payer mix
$25,000
flat
Implementation Services
White-glove onboarding for Enterprise customers. We map your current denial inventory to the playbook, configure custom payer overlays, and integrate with your billing platform.
Delivery: 6–8 week engagement with dedicated implementation lead
Best for: New Enterprise customers
$50k–$150k/yr
White-Label License
Embed the entire 6QD Denial Playbook inside your own RCM service offering, branded as your product. Co-marketing and co-selling rights included.
Delivery: Custom branding + API + revenue-share negotiable
Best for: RCM consulting firms (Ventra, Savista, Conifer, etc.)
$1,500/seat
or $25k/cohort
Training Certification Program
Multi-day certified facilitator program using our 79 Facilitator Guides. Hospital training departments earn AHIMA/HFMA continuing-education credits.
Delivery: Live virtual or on-site, certificate issued on completion
Best for: Health system training depts, AHIMA/HFMA chapters
What Makes Us Defensible
Not generic content. Not a code lookup tool.
The depth and structure of our content is the moat. Six things you won't get from competitor products:
CARC+RARC pair-specific SOPs
117 pair-specific scenarios. Competitors are CARC-level only. Reps stop getting generic content and start getting "here's exactly what to do for 16+M15 vs. 16+N4."
Template letters in your voice
100+ standardized smart placeholders, scenario-specific. Time-to-appeal collapses from hours to minutes.
Training-ready facilitator guides
79 trainer-facing companion guides — Socratic-question format with 9 sections and 8 learning objectives each. Most products skip this entirely.
Tier classification + Automatable flag for staffing decisions
Every scenario is tagged Tier 1/2/3 AND Automatable Yes/Partial/Claim Scrubber/No AND Technical vs. Clinical. Directly ties SOP content to FTE allocation: Tier 1 + Automatable Yes = bot it. Tier 3 + Clinical = senior or RN-level. No other product gives you all three dimensions per CARC+RARC combo.
Site-of-service variants
For complex codes (e.g., CARC 150 + RARC N610), distinct SOPs for ED, Inpatient, and Outpatient settings.
Conditional decision trees
Authorization scenarios (CARC 197 family) include real if/then logic — not generic guidance.
Frequently Asked
Common questions about pricing & access.
Can I try Foundation before committing annually?
Yes — month-to-month at $499 with no commitment. The annual option ($4,990/yr) saves 17% but is optional.
How is Enterprise priced?
Net Patient Revenue tiered: 0.005% of NPR for facilities under $100M, 0.003% for $100–500M, 0.001% for $500M+, capped at $150k/year. Small hospitals start around $25k; large systems land at the $150k cap.
Do I need the SOPs to license the Tiers Master data?
No. Tiers Master is available as a standalone data license ($4,999/yr or $999/month) for analytics vendors, BI teams, and platforms that want the taxonomy without the operational playbook.
How often is content updated?
When CMS issues a new CARC, subscribers on the New-CARC Issuance Retainer ($5k/yr add-on, included in Enterprise) get a fully-structured SOP within 30 days. Quarterly content reviews otherwise.
What about HIPAA / data security?
No PHI ever touches our systems. Customers upload de-identified denial mix data (CARC code + frequency) for the Pareto report feature. Our content is reference material — your operational data stays in your environment.
Can RCM consulting firms white-label the product?
Yes — the White-Label License ($50k–$150k/year, depending on customer base size) lets you embed the entire playbook inside your service offering, branded as your product, with API integration and co-marketing rights.
Not sure which tier fits?
We'll review your denial mix, current FTE allocation, and integration needs — then recommend the right entry point. 30-minute call, no commitment.
Talk to our teamOr try the free CARC search first.